This description of Abdelaziz Allabadi's work was prepared when Abdelaziz Allabadi was elected to the Ashoka Fellowship in 2017 .

Introduction

Abdelaziz is popularizing medical information in the Arab region. He is doing so by facilitating access to medical information by creating and publishing updated, authenticated, Arabic medical content online. He is also facilitating the connection between medical doctors and patients, by enabling patients to ask questions and doctors to answer them with a variety of options instantly.

The New Idea

Abdelaziz is closing the gap of medical information in the region, which has thus far only been accessible to medical doctors educated in foreign languages. Published information is crucial to the lives of Arabs, the majority of whom only speak Arabic. Through medically-substantiated content created specifically for his online portal “Altibbi.com”, patients from diverse socio-economic backgrounds get free access to medical content covering health issues relevant to them such as dental problems, blood pressure related issues, diabetes, eye diseases, skin disorders, sexual health, and the like. He began by producing the first Arabic-Arabic dictionary that included more than 86 medical specializations and then granted free-access to that content by putting it online, increasing the capacity of understanding health-related issues by the masses in the Arab World.
To enable scale and sustain the change that he champions, Abdelaziz engages the community of volunteering doctors on his platform. Alitibbi.com ensures the easiness of instantly accessing needed information by patients through the availability of various articles. He incentivizes the doctors by giving them access to detailed demographic information about patients that can enhance the quality of diagnosis of symptoms and methodologies of treatment. Doctors also gain recognition, validation and promotion in the eyes of their patients by having published articles. Furthermore, patients can easily ask online follow-up questions that can be answered by different medical doctors and general practitioners. When inquiries by patients are resolved, referrals to specialized doctors are provided.

The Problem

Medical doctors in the MENA region study medicine in English or French. This prompts a challenge in the communication between doctors and patients, as the English Proficiency Index of MENA is 43, which is the lowest in the world, compared to Asia which is 56, according to Education First. According to this index, the countries of the region have scores of maximum 55. Moreover, in this region, physicians are only accessed through clinics which do not give space for doctors to educate and raise awareness of their patients about diseases, symptoms and mechanisms of prevention. Moreover, according to the World Bank, in Egypt, Levant, and the Maghrib Region the percentage of total expenditure on health of the gross domestic product is around 5-7%, compared to Germany, Belguim, Denmark and France which is 11%. That impedes the provision of services such as health insurance and access to specialists and hospitals around the region, thus making it harder for Arab citizens to access quality medical information and expert-based advice.
Furthermore, the access to digital information on internet reached 33% of Internet users in Egypt, which is equivalent to 31 million individual out of 93 million; looking at the bigger image, in the Arab Region there are 144 million individuals looking for medical information on the Internet out of 394 million. However, only 3% of online global content is in Arabic; hence, there is a need to provide Arabic content to the 144 million Internet users in the Arab region seeking medical content. This need is also due to several factors, one of which is the unavailability of basic Arabic medical information online. Providing such information will help enrich the knowledge of individuals concerning medical issues they face. In addition, there is limited access to general practitioners whose role is to treat different conditions and most importantly are responsible for referring patients to the right specialists, for example if patients face an intersection of medical issues that is hard for them to decide which specialist to go to, the general practitioner intervenes for guidance; this role is something lacking nowadays in the region. On the other hand, there is a lack of family doctors who are specialized doctors responsible for families that can help the patient with his knowledge in the field or refer him to other specialized doctors. Finally, doctors are turning medical practice into business not a humanitarian act or a belief. Accordingly, patients are granted short periods of time for checkup that permits the doctor to only do a quick checkup and write a pertinent prescription.
Meanwhile, in the Arab region there is an increase in internet access. Also, access to medical information in Arabic is not limited to a specific country but is prevalent across Arab countries and beyond. By increasing the knowledge of doctors about disease patterns and about their patients, the problem will not be reproduced and will be reduced. The situation is even worse in countries like Jordan, where refugee populations from neighboring countries are not permitted access to government subsidized healthcare, thus Altibbi.com can be a powerful tool. Altibbi.com is the first initiative that popularizes medical content in the Arab region. WebTeb is another web platform that offers medical essays online; it started with pregnancy related issues and then incorporated other specializations. Besides starting after Altibbi, what WebTeb lacks is the movement and engagement that Altibbi.com creates between doctors and users. Through that movement, people are connected with experts who they didn’t previously have access to on that scale and with that time efficiency. Altibbi.com develops its local and proprietary content, and collaborates with local doctor communities to publish their work on the website. It is unique, as it believes in the power of interaction between patients and doctors, which again is what WebTeb lacks. Another web platform that is developed in the Arab region is Shezlong; Shezlong is a platform to bring online psychological therapy to anyone in the Middle East North Africa “MENA” region who struggles with the daily battle of their own mind. Shezlong provides anonymous, online contact with professional, certified therapists. The services are provided through videoconference therapy sessions and online chat-rooms. As stated, it only deals with the psychological part of the individual, it lacks all the other issues that an individual might face concerning his physical health; this is what Altibbi was successfully able to merge and focus on. Lastly, Super Mama only focuses on pregnant women and their health by posting articles that help mothers maintain a healthy lifestyle. It lacks the communication between doctors and patients that Atibbi provides.

The Strategy

Abdelaziz created a web platform where medical doctors as well as content creators such as pharmacy doctors, general practitioners, and specialized medical doctors who are active by writing articles, and replying to patients’ questions online or through a newly launched service started a year ago- a 24/7 hotline service. Articles are written by specialized doctors, for patients to receive reliable information and knowledge about different issues, whereas doctors gain a reputation and become well-known in the society, attracting more patients to their private clinics. Abdelaziz gives patients access to general practitioners through his platform who are responsible for answering phone calls in order to provide guidance by referring the patient to the doctor whose consult they need, or by giving them various possibilities that can for example be to direct them to a radiology center, hospital or undergoing any type of analysis. Finally, the three providers of medical content on Altibbi.com, who are pharmacy doctors, general practitioners, and specialized medical doctors, are responsible to answer online questions with basic information while stating the possibilities and referral to specialized doctors.
Altibbi.com has a process of authenticating published information and doctors. Doctors are chosen by referring to the medical syndicate in each country and also through communication with universities in Jordan to choose general practitioners and pharmacy doctors, since Jordan is the only Arab country that has this division. To start, articles are written by specialized doctors; each one writes in his/her own specialty based on their experience and proper knowledge. In addition, Altibbi.com does not accept to publish articles that are copied from other sources or written by other authors. Moreover, there is a team observer for the site that is given the absolute right to modify or remove any user generated content if it contains any content not related to the medical field and plagiarized content. They also focus on creating articles using clear and direct terms while dealing in depth with the content, and avoid the informal style conversation common in other sites to serve the purpose of the medical article, which is to form a reliable medical source. Concerning the interaction between the doctors and the users of the websites, there is an open platform for questions and answers. The team observer avoids informal conversation; this is done to serve their purpose, which is to form a reliable medical source. They also advise users to write a scientific question with a clear and direct concern, without relating it to any personal issues.
Altibbi.com also focuses on connecting to trusted doctors using different mechanisms. First, medical doctors who are in good standing in their respective countries of residence, are vetted through Altibbi.com internal process, by receiving on boarding documentation including the policies and procedures; in addition their first activities are monitored closely on the platform by the team. As for the process of answering and distributing questions on doctors, Abdelaziz managed to build a system that analyzes the question and accordingly automatically categorizes it to be sent to different active doctors who can answer that question. The efficacy of automation process is crucial as the more questions get answered; the more doctors get engaged with answering the questions. That in turn will contribute in scaling the movement of popularizing access to medical information by getting more questions answered, more article published, more phone calls answered, and hence more daily users. In 2015, Abdelaziz managed to add another process on his platform, which is phone calls that increases the engagement between doctors and patients, which had about 1000 subscriber in the first few months. The process is divided into 4 factors: it is limited to the geography like Egyptian users call only Egyptian Doctors for example; expert based opinion that refers the patients to the right doctor; instant access in case of emergencies; and subscription service: for $5 per month through which subscribers receive unlimited, 24- hour access to Altibbi.com network of medical doctors. The medical doctors take part of this fee as a return for their work.
Altibbi.com has a huge impact on the access of medical information in the Arab region. It is attracting more than 300k unique daily visitor, more than 45k queries from users per month; has 625k users in total, 10,000 doctor, 150 doctors available at any moment, 24k phone calls, 500k answered questions, 5k medical essays published by medical doctors, 1k questions are answered each day and it covers conditions, treatments, medications and tests in more than 88 medical specialties. On the top of that, the Key Performance Indicators (KPIs), according to which Abdelaziz measures the performance of Altibbi.com are unique visitors, number of free questions submitted, number of active doctors/day, conversion rate to paid user, retention rate of unpaid users reached 60%, which refers to users that uses all the services except for the phone calls. However, regarding paid users who can also use phone calls the newly launched service, their retention rate reached 28%.
Altibbi.com is now trying to enhance the used technology to facilitate answering more questions and publish more medical content. It currently has 1.5M pages of medical content on the platform. Abdelaziz is also going to work on developing the Arabic-Arabic dictionary to add more specialties and more terminologies in each specialty. With more medical content, Abdelaziz will be able to reach out to more doctors to build on the movement that he is championing. Abdelaziz is also going to extend the value to the patients in a region with low insurance coverage and high hospitalization rates through working with 89 countries like Jordan to inform the discourse on public health and health policy. That will take place through the content generated on Altibbi.com, which will lead the government to focus on subsidizing medical services that speak to the need of its citizens.

The Person

AbdelAziz was born in 1946 to a family that used to live in Haifa/Palestine until 1948. His father was a merchant, and Abdelaziz grew-up in between the West Bank and Jordan. From an early age, Abdelaziz used to work in refugees camps, especially in Lebanon. Through that experience, he came to know what means to not have an access to medical service could look like and how this would impact millions of lives.
In the Siege, at the refugee Camp of Tal el Zaatar in Lebanon in 1976, he learned how important knowledge could be. As part of the Red Crescent, he trained more than 100 girls on first aid. Through that experience he came to know that knowledge is power in the sense that the refugees will not always be under the mercy of doctors who are under continuous bombardment. At that time, he was one of the two doctors who were serving over 30,000 refugees.
In 1988, he started his work on popularizing medical content. He first started by putting together the Arabic-Arabic Medical dictionary on his own. At first, no one (fellow doctors and friends) saw a reason to give him support, believing that his work was pointless. He kept accumulating material and writings for the dictionary until 2000s. After he finished his dictionary, he was keen to publish it. At that time, his son Jalil was doing his MBA and together they decided to publish it online for a wider access. The online platform – Altibbi.com – first saw light in 2008. Even then Abdelaziz was not satisfied with reaching that point. He then decided to add more medical essays to the new online platform. Jalil and his cousin started to develop the financial model and to add more features to the website. Meanwhile, through the feedback that Abdelaziz got from his fellow doctors, Abdelaziz decided to add an engagement element between doctors and people. At that moment, he started to build movement that connects medical experts with the masses and better popularizes medical content.